Injury elimination and survival: a cross-national study

Injury is potentially avoidable. In this study, nine industrialized countries were compared on the projected impact upon population survival of hypothetically eliminating injury mortality. Three principal research questions were addressed. Computer simulations were performed using a combination of single decrement, multiple decrement and cause-elimination life table techniques. Data pertained to 1992. French and American males exhibited the largest projected addition to life expectancy at birth of 2.1 y. They were followed by Canadian and Spanish males with gains of 1.6 y, respectively. Among females, the French were the leading beneficiaries with an added 1.1 y, followed by Americans with 0.8 y. Male gains typically were twice the female gains. Highlighted as relative injury problems were homicide for the US population, traffic fatalities for the Spanish population, and suicide for Japanese females. Among the hypothetically spared, American males registered the largest average projected benefit for either sex of any nationality with 31 additional years of life. At the other extreme were Dutch females with an extra 16 y. For persons exact age 15 of either sex, the greatest projected improvements in survival between ages 15 and 65 would occur for the French. French and US populations manifested the largest injury mortality burdens and British and Dutch the smallest. But survival benefits accruing from the injury mortality elimination varied considerably across nation and sex according to the nature of the life table analyses conducted.